Time / Date: 3/7/2025 9:50:04
JSP ID: 3482
Scope of Work: Switch Safety Racks back on
Work Order: 415062
Building: 6ALS
Person in Charge: Christopher
Lead / Supervisor: Combs, Everett
Logged Email: cnelson@lbl.gov
Division: Facilities
QEW Level: QEW 2
Modes of Work: Mode 0 - Electrically Safe Work Condition
Second Person Requirement: Not Required
Second Person Identified:
List Other Participants:
Affected Persons Notified: Yes
Switching: Non-Hazardous Switching
Panel / Equipment ID: 314A/Ba So1314, 318A/, S061314, 322A/S01013
System Information Review: Panel Schedules, Arc Flash Labels
Control of Hazardous Energy: LOTO Not Required (Mode 2 or 3 only)
Equipment Condition:

Sequence of Job Steps

List basic sequence of steps from start to finish.

Meet with Mary Chan in sector 2 and then sector 6 and last 10. Fill out JSP Switch breaker feeding racks with proper PPE

Control of Work Area

Minimum Approach Boundary:
Barricade Tape / Attendant:

Shock Risk Assessment

System Voltage: No Shock Hazard Present
Limited Approach Boundary: 42 inches
Restricted Approach Boundary: 3 inches
Will the hands enter the RAB: No
Voltage Glove Class: Not Required
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: 16.8, 16.9, 17.3 cal/cm2
Arc Flash Boundary: 94”, 94”,96”
Working Distance: No Arc Flash Hazard Present
Arc Flash PPE Level: Minimum PPE for Electrical Work
Incident Energy Reduction Measures: Not Required

Capacitor Hazards

Capacitor Bus Voltage:
Capacitor total stored energy (joules):
Discharge wait time (minutes):

Emergency Response Plan

Nearest Landline Location: On the safety racks
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Building 15 lobby
Fire Extinguisher Location: In pit near racks and labyrinth entrance to tunnel
Contact release method available and tested: Na

Environmental Conditions

Does the environment present additional hazards that should be addressed?

None

Error Precursors

Task Demands: Time pressure (in a hurry)
Work Environment:
Individual Capabilities:
Human Nature: Mind-set
Error Precursor Mitigations:

Be aware of look alike equipment make sure we are in contact with Mary Chan and switch the right breaker

PPE Inspections

Na

Notes / Other

Just switching be aware of look alike equipment mark the breaker with tape that is to be switched.

Perform Job Breifing

PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.

A Job Briefing at a minimum must include:
  1. Detailed Scope of Work
  2. Shock and arc flash hazards for each task
  3. Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
  4. Work area controls (barricades, signs, attendants)
  5. Emergency Response Plan

Rev 2023.08.22.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov